CHRONIC PAIN

The Challenge

There are many disorders of the peripheral and central nervous system that cause chronic pain. The pathophysiology of nerve injury in chronic pain is highly complex and often leads to unpredictable responses to treatment options. Patient history, physical exam and other standard tools have traditionally been the only options available to evaluate the nociceptive system. These tests have very limited sensitivity and are often skewed by inherent examiner bias. Imaging methods are common diagnostic tools, although limited in their static picture of anatomy. Since imaging tests do not measure nerve function, they are associated with a significant number of false-positives. EMG and nerve conduction testing do not evaluate small-caliber, pain-mediating C and A-delta fibers.

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Why QST?

Thermal testing is essential in the scientific evaluation of small-caliber A-Delta & C-Fibers, the primary transmitters of thermal and pain sensation. Quantitative Sensory Testing (QST), widely regarded as the “Gold Standard” of thermal testing, is the only test that quantitatively assesses the function of somatic small fibers – from peripheral receptors through their central nervous system connections. This is where the secret behind presenting pain lies.

Much research in chronic pain strengthens the growing trend to recognize and mandate pain as the “fifth vital sign.” This is due to a limited understanding of the basic mechanisms of pain. Without a detailed diagnosis that reflects the underlying pathophysiology of pain, treatment is often random guesswork. Understanding the basic pathophysiology of pain can help physicians provide optimal and medically justifiable treatment.

QST and Advanced QST offer quantitative data that enables physicians to individualize and balance the diverse approaches, to reach an optimal treatment modality in complex chronic pain. By understanding the cause, physicians have the tools they need to effectively treat patients with better pain relief.